Governance and Primary Health Care in South Australia

Staff involved: Gwyn Jolley

Community health workers are very aware of the changes to structures and processes that have taken place under the reform process following the Generational Health Review. One visible change has been a change in name for many of the services.

In 2005 SACHRU undertook a pilot project with the Southern Adelaide Health Service to begin the evaluation of changes in primary health care under the new governance structures. The study aimed to address the questions:

What is the most effective way to organise health service governance in order to promote and strengthen primary health care?

How does a change in health service governance affect the position of primary health care in relation to acute care health services?

The final stage of the pilot project was the development of a draft, regional goals, strategies and indicators framework for primary health care. This was presented and discussed in a forum of over 50 participants including representatives from the three regional health services in Adelaide, rural health services and the SA Department of Health. The framework details strategic indicators of progress in achieving a major reorientation of the health system towards primary health care. The framework, which will be further revised, will allow us to track the progress of the regions in meeting primary health care goals and objectives.

With a number of other partners SACHRU applied for funding to continue this work. A successful application to the University Industry Collaborative Grant Scheme at Flinders University allows us to build on the momentum achieved through this pilot work for a further 12 months. We will extend the scope of the work to include the Central Northern Adelaide Health Service and the Children, Youth and Women's Health Service. This research will contribute to our understanding of the impact of health care reform by assessing and evaluating changes in primary health care under new governance and community participation structures.

The team will submit an ARC Linkage Grant application to continue this work beyond 2006, allowing longer-term assessment of the impact of the regional health structures in Adelaide on primary health care.